P-010: TREATMENTS FOR SICKLE CELL DISEASE (SCD) AND THE HEALTHCARE PROFESSIONAL (HCP)–PATIENT RELATIONSHIP: HCP OPINIONS FROM THE INTERNATIONAL SICKLE CELL WORLD ASSESSMENT SURVEY (SWAY)
Authors: ANDEMARIAM B., JAMES J., MINNITI C., INUSA B., EL RASSI F., NERO A., TRIMNELL C., ABBOUD M., ARLET J., COLOMBATTI R., DE MONTALEMBERT M., JAIN S., JASTANIAH W., NUR E., PITA M., DEBONNETT L., BAILEY T., RAJKOVIC-HOOLEY O., OSUNKWO I.
Journal: HemaSphere (2022)

Purpose: HCP specialty and care setting may influence the care that SCD patients receive (Smeltzer et al. BMJ Open 2021). This analysis of SWAY reports potential differences in the treatment and management of SCD by HCPs, based on HCP specialty and care setting. Materials and methods: SWAY was a cross-sectional survey of patients with SCD aged ≥6 years (N=2145) and HCPs (N=365) developed by international SCD experts, patient advocates and Novartis to assess patient and HCP experiences of SCD (conducted between April and October 2019). Eligible HCPs had qualified in their primary specialty by 2014 and were managing ≥10 SCD patients at the time of the survey (≥5 patients/HCP in Canada; ≥2 patients/HCP in the Netherlands). Data reflect only the experiences of the surveyed HCPs (recruited by Adelphi Real World Network). Results: HCPs were grouped by specialty (hematology, n=150; hematology–oncology, n=101; pediatric, n=31; general practitioner [GP], n=50; and other [internal medicine specialist, emergency department physician, physician assistant, nurse/nurse practitioner, other], n=33) and care setting (SCD center, n=46; university/teaching hospital, n=105; regional center/community hospital, n=57; private hospital/office, n=109; and other [health center and other], n=48). Acute (vaso-occlusive crisis [VOC]) pain was reported as one of the most common symptoms discussed with patients by most hematologists (82%), hematologist–oncologists (79%) and pediatricians (87%); reported as a discussed symptom by 54% of GPs and 42% of other HCPs (chronic pain was reported by 78% of GPs and 70% of other HCPs). Hydroxyurea (HU) – a treatment for VOCs – was initiated by 97% of hematologists, 88% of hematologist–oncologists and 90% of pediatricians versus 14% of GPs and 30% of other HCPs. More hematologists, hematologist–oncologists and pediatricians ranked reducing VOCs as a top treatment goal above reducing chronic pain levels; the opposite was true for GPs and other HCPs (Table). Exchange and standard blood transfusions were initiated by more HCPs at SCD centers and university/teaching hospitals than at other care settings (Table), although fewer HCPs at SCD centers versus other care settings reported iron overload as a complication patients experienced (SCD center, 26%; university/teaching hospital, 40%; regional center/community hospital, 47%; private hospital/office, 31% and other, 42%). HCPs at SCD centers were also more likely to provide information to patients in the form of leaflets or direct them to patient support groups (leaflets/patient support groups: SCD center, 70%/63%; university/teaching hospital, 60%/47%; regional center/community hospital, 49%/30%; private hospital/office, 59%/33%; other, 60%/33%). Conclusion: Hematologists, hematologist–oncologists and pediatricians in SWAY were more likely to discuss VOCs during consultation with their patients than GPs or other HCPs, a possible reason for why fewer GPs and other HCPs reported initiating HU than the other groups analyzed. Furthermore, HCPs at SCD centers appeared to be more likely to initiate certain SCD treatments than those at other care settings. Results from this analysis of SWAY support a multidisciplinary and collaborative approach to SCD care in order to optimize patient outcomes, with distinct but vital aspects of patients’ needs fulfilled by each HCP specialty and care setting.Table. Top 10 therapies ever initiated to patients of any age, stratified by HCP specialty and care setting C. MINNITI declares a conflict of interest: Consultancy, Expert: Bluebird bio, Novartis, Sanguine Bio, Emmaus, Forma, Agios B. INUSA declares a conflict of interest: Consultancy, Expert: Novartis ltd Global therapeutics Vertex Agios Forma Invitation to national or international congresses: Italian society nigerian blood transfusion society Research support/Scientific studies: Agios African Research and Innovative Initiative for sickle cell Educatiion (ARISE) www.ariseinitiative.org Trainings, Teaching: academy for sickle cell and thalassaemia (ASCAT J. ARLET declares a conflict of interest: Consultancy, Expert: Yes Invitation to national or international congresses: YES Research support/Scientific studies: YEs M. DE MONTALEMBERT declares a conflict of interest: Consultancy, Expert: Novartis, Addmedica, BlueBirdBio, Vertex Invitation to national or international congresses: Addmedica Research support/Scientific studies: Addmedica Trainings, Teaching: Addmedica